Prolonged Bottle-Feeding and Iron Deficiency

The study involved more than 2,100 children ages one to three years who took part in the National Health and Nutrition Examination Survey (1988-1994). Among these children, the prevalence of iron deficiency was six percent among whites, eight percent among blacks and 17 percent among Mexican Americans.

Researchers learned that the longer children were bottle-fed, the higher the prevalence of iron deficiency. That was especially true of Mexican American children, who were most likely to be bottle-fed for prolonged periods of time and had very high rates of iron deficiency. At 24 to 48 months of age, 36.8 percent of Mexican American children were still bottle-fed, compared with 16.9 percent of white and 13.8 percent of black children.

“Toddlers who are bottle-fed consume large volumes of non-iron-fortified milk. This results in gastrointestinal blood loss together with a displacement of iron-rich foods from the diet,” according to Jane Brotanek, M.D., M.P.H., assistant professor of paediatrics at the Medical College of Wisconsin. She says the problem is important because iron-deficiency anaemia in infancy and early childhood is associated with behavioural and cognitive delays. Iron deficiency and iron-deficiency anaemia affect 2.4 million children in the world, with almost half a million children affected in the United States alone.

Dr. Brotanek points out that because of the harmful long-term effects of iron deficiency, its prevention in early childhood is an important public health issue. The study concluded that screening and nutritional counselling practices should be modified to address the increased risk of iron deficiency among children with prolonged bottle-feeding, especially among Mexican-American toddlers.